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Objective:To assess the value of S-Detect and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of Breast Imaging Reporting and Data System(BI-RADS) 4 breast lesions.Methods:A total of 104 breast lesions in 100 patients diagnosed as BI-RADS category 4 by conventional ultrasound were prospectively enrolled, and all of them were received S-Detect and CEUS examination at the same time. Taking pathology as the gold standard, ROC curve was constructed to compare the diagnostic efficacy of conventional ultrasound, S-Detect, CEUS and their combination.Results:Among the 104 BI-RADS category 4 breast lesions, 63 were benign and 41 were malignant. The sensitivities of conventional ultrasound, S-Detect, CEUS and S-Detect combined with CEUS were 73.17%, 87.80%, 87.80%, 90.24%; the specificities were 57.14%, 60.32%, 68.25%, 77.78%; the positive predictive values were 52.63%, 59.02%, 64.29% and 72.55%; the negative predictive values were 76.60%, 88.37%, 89.59% and 92.45%; the accuracies were 63.46%, 71.15%, 75.96% and 82.69%; and the areas under the ROC curve (AUC) were 0.652, 0.741, 0.780 and 0.840. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of S-Detect and CEUS diagnosis were improved compared with conventional ultrasound. The AUC of combined diagnosis was higher than that of S-Detect, CEUS alone, and the differences were statistically significant(all P<0.05). The AUC of CEUS was higher than that of conventional ultrasound, and the difference was statistically significant ( P<0.05). There were no significant differences in AUC between any two of other groups (all P>0.05). Conclusions:The combined application of S-Detect and CEUS could achieve complementary advantages, which is of great significance for the differential diagnosis of benign and malignant in BI-RADS 4 breast lesions.
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Objective:To investigate the value of contrast-enhanced ultrasound (CEUS) in the diagnosis of malignant endometrial lesions.Methods:A total of 142 patients with endometrial lesions who underwent contrast-enhanced ultrasound examination in Beijing Tiantan Hospital, Capital Medical University from January 2019 to September 2021 were selected. The endometrial lesions were divided into benign group (including endometrial hyperplasia and endometrial polyps) and malignant group (endometrial cancer) according to the pathological results of surgery, and the differences of contrast enhancement patterns between benign group and malignant group were compared. The sensitivity, specificity of CEUS in the diagnosis of endometrial cancer were calculated, and the Kappa value was calculated with the initial enhancement time earlier than or equal to the muscularity or the peak time earlier than the muscularity as the diagnostic index for the diagnosis of endometrial malignant lesions. The sensitivity, specificity, and Kappa value of CEUS in the diagnosis of endometrial cancer and endometrial cancer with thickness ≥10 mm were calculated.Results:A total of 108 patients underwent surgery with clear pathological results, including 66 patients in the benign lesion group and 42 patients in the malignant lesion group. The thickness of malignant lesions was significantly larger than that of benign lesions, and the difference was statistically significant( t=4.039, P<0.05), but there was no significant difference of hemodynamic parameters between the two groups ( P>0.05). The initial enhancement time, peak time and peak intensity of benign lesions were significantly different from those of malignant lesions(all P<0.05). The sensitivity, specificity, and Kappa value of CEUS in the diagnosis of endometrial cancer were 64.3%, 100% and 0.668, respectively. The sensitivity, specificity and Kappa value of CEUS in the diagnosis of endometrial carcinoma with lesion thickness ≥10 mm were 75.0%, 100% and 0.795, respectively. Conclusions:For the diagnosis of endometrial lesions, especially the malignant endometrial lesions with thickness and diameter greater than or equal to 10mm, there is a high diagnostic coincidence rate between CEUS and pathological diagnosis, and endometrial malignant lesions have more specific CEUS manifestations.
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Objective:To investigate the ultrasound characteristics of benign and malignant endometrial lesions in postmenopausal women terminology.Methods:Patients with endometrial lesions who underwent transvaginal ultrasound examination in Beijing Tiantan Hospital affiliated to Capital Medical University from January 2019 to November 2021 were selected.Pathological diagnosis after surgery was used as the gold standard, and endometrial lesions were divided into a benign group(including endometrial hyperplasia and endometrial polyps)and a malignant group(endometrial cancer)according to surgical pathology results.Endometrial thickness and Doppler flow parameters were compared between the benign group and the malignant group.The chi-square test was used to compare the echogenicity, the presence or absence of cystic areas, the integrity of the endometrial-myometrial junction, the blood flow score, and the blood supply vessels between the benign and malignant groups.A prediction model was established according to the ultrasonic characteristics.Results:A total of 136 participants received surgery at our hospital with definitive pathological diagnoses, including 72 patients in the benign group and 64 patients in the malignant group.Peak systolic velocity(PSV) and end diastolic velocity(EDV) in malignant lesions were higher than those in benign lesions[(28.75±14.66)cm/s vs.(22.94±13.62)cm/s, (14.75±8.10)cm/s vs.(11.56±6.21)cm/s]. The thickness of malignant lesions was significantly greater than that of benign lesions[(19.31±8.97)mm vs.10.14±4.31)mm], and the blood flow resistance index was lower than that of benign lesions(14.75±8.10 vs.11.56±6.21). The differences were statistically significant( t=2.393, 2.597, 7.452, 2.028, all P<0.05). The prediction model was established based on the above ultrasonic characteristics.The area under the ROC curve for ultrasound physicians to diagnose benign and malignant endometrial lesions was 0.905( P<0.001), indicating that the prediction model had high diagnostic value. Conclusions:Both benign and malignant endometrial lesions in postmenopausal women have different ultrasonic characteristics.Malignant lesions tend to have a larger lesion thickness, an interrupted or irregular endometrial-myometrial junction, higher blood flow signal scores, and multiple blood supply patterns.The ultrasonic prediction model has high diagnostic value for benign and malignant endometrial lesions.
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Objective:To explore the correlation between the characteristics of contrast-enhanced sonography of intraoperative glioblastoma multiform (GBM) and molecular markers of isocitrate dehydrogenase-1(IDH1).Methods:A retrospective analysis were performed in 30 patients who underwent neurosurgery and pathologically confirmed to be GBM at Beijing Tiantan Hospital from May 2018 to April 2019. All neurosurgical glioblastoma patients after craniotomy underwent conventional ultrasound and contrast-enhanced ultrasound(CEUS) guided navigation. The characteristics of the ultrasound imaging (whether the tumor involves the structure of the corpus callosum, the clarity of the tumor boundary after enhanced ultrasound and whether the tumor has necrotic areas with enhanced ultrasound images) were analyzed. The ratio between tumor necrosis area and whole tumor area (N/W) was measured, and the correlation with IDH1 gene expression was analyzed.Results:There were statistical differences in clarity of tumor boundary after CEUS and tumor necrosis after CEUS between positive IDH1 and negative IDH1 groups(all P<0.05). The positive expression of IDH1 was negatively correlated with the N/W area of the contrast-enhanced ultrasound mode( r=-0.756, P<0.05), suggesting that the expression level of IDH1 gene was negatively correlated with the area of tumor necrosis. Conclusions:Ultrasound contrast agent examination can more accurately distinguish the active proliferation area, hemorrhagic necrosis area and peripheral edema area of glioblastoma. Accurately identifying the extent of tumor necrosis area through ultrasound contrast agent examination can predict expression of IDH1.
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Objective:To explore the value of different levels of sonographers and International Ovarian Tumor Analysis (IOTA) simple rules in judging benign and malignant ovarian tumors.Methods:The ultrasound images of 182 patients treated in Beijing Tiantan Hospital, Capital Medical University from January 2017 to November 2020 with ovarian tumors were retrospectively analyzed. The ovarian tumors were diagnosed by two senior sonographers and two junior sonographers without knowing the pathological diagnosis. Another junior sonographer trained in IOTA terminology and simple rules applied IOTA simple rules to diagnose 182 ovarian tumors. The sensitivity, specificity, positive predictive value and negative predictive value of the diagnosis of ovarian tumors by senior sonographers, junior sonographers and IOTA simple rules were calculated using the postoperative pathological diagnosis as the gold standard. The Kappa value was calculated for the consistency between different levels of sonographers and the IOTA simple rules and pathological diagnosis.Results:Of the 182 cases, 61 cases were pathologically benign and 121 cases were pathologically malignant. The diagnostic sensitivity, specificity and accuracy of senior sonographers were 93.4%, 99.2%, 97.2%, respectively, Kappa value was 0.938. The diagnostic sensitivity, specificity, and accuracy of junior sonographers were 80.3%, 90.0%, 86.8%, respectively, Kappa value was 0.704. The diagnostic sensitivity, specificity and accuracy of IOTA simple rules(When an uncertain tumor was classified as malignant) were 95.0%, 73.5%, 80.7%, respectively, Kappa value was 0.614. The diagnostic sensitivity, specificity and accuracy of IOTA simple rules(when an uncertain tumor was excluded) were 94.2%, 90.9%, 92.0%, respectively, Kappa value was 0.834.Conclusions:IOTA simple rules is a very useful diagnostic tool for junior sonographers to judge benign and malignant ovarian tumors. When IOTA simple principle is judged as an uncertain case, it is recommended to refer to experienced senior sonographers for further diagnosis.
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Objective@#To analyze the ultrasound examination and computed tomography angiography (CTA) features of carotid web(CAW), and compare with the pathology after carotid endarterectomy, and then compare diagnostic efficacies of the two methods.@*Methods@#From June 2018 to July 2019, 159 patients underwent carotid endarterectomy(CEA) in Beijing Tian Tan Hospital were collected, ultrasound examination and CTA were performed preoperatively. The presence or absence of CAW and whether there were thrombosis or atherosclerotic plaques associated with it were identified. The location length, thickness, direction in the lumen, echo characteristics of CAW, and complicated with or without thrombosis or atherosclerotic plaques were recorded. The postoperative specimens were observed, and the pathological analysis was performed.@*Results@#Among the 159 cases of CEA, 22 cases were confirmed to have CAW structure by pathology, and HE staining showed extensive intimal fibrohyperplasia and mucoid degeneration, among which 18 cases had plaque formation at the bottom of the carotid web, and 4 cases associated with thrombosis. There were 17 cases of CAW structure diagnosed by ultrasound, 5 cases were misdiagnosed or missed, the sensitivity and specificity of ultrasound in the diagnosis of CAW were 77% (17/22) and 98% (135/137), and the accuracy was 75%. Eleven cases of CAW were diagnosed by preoperative CTA, and 11 cases were misdiagnosed and missed diagnosis, the sensitivity and specificity of CTA in the diagnosis of CAW were 50%(11/22) and 97%(134/137), and the accuracy was 47%.@*Conclusions@#The sensitivity of ultrasound in the diagnosis of CAW is higher than that of CTA, which can better display the structure of CAW and whether it is associated with plaque or thrombosis.
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Objective:To evaluate the mechanical parameters of the carotid artery plaques using velocity vector imaging(VVI), and to investigate the correlations between the mechanical parameters and the histological components in the plaques.Methods:Fifty-three patients undergoing carotid endarterectomy (CEA) from April to December, 2019 in Beijing Tiantan Hospital were selected and underwent VVI examination before operation. The plaques were divided into 5 parts along the long axis and named as R1, R2, R3, R4, R5, respectively. The mechanical parameters of the plaques in each region of interest were measured(longitudinal strain and strain rate). After operation, plaques were collected in 49 cases and the specimens were divided into five sections corresponding to preoperative images for HE staining and CD68 immunohistochemical analysis. According to the pathological diagnostic criteria of unstable plaques in previous studies, all plaques were divided into stable group and unstable group. Image-pro Plus 6.0 analysis software was used to measure the number of macrophages and the percentage of lipid core in plaques and the mean integral optical density of CD68 positive reaction area.Results:Among 49 cases, 33 cases were for unstable group, 16 cases were stable group. The longitudinal strain and strain rate of two groups of patients were R1>R2>R5>R4>R3, the number of macrophages, mean integral optical density, and percentage of lipid core were R2>R3>R1>R4>R5, differences were statistically significant ( P<0.05), the above indexes in unstable group were higher than in stable group, but there was no statistically significant difference ( P>0.05). The longitudinal strain was positively correlated with the number of macrophages, mean integral optical density and lipid core content in the plaque( r=0.300, 0.255, 0.394 respectively, P<0.05), and the strain rate was positively correlated with the number of macrophages and lipid core content in the plaque( r=0.199, 0.214 respectively, P<0.05) and r values in R1-R2 were higher than in R1-R5(longitudinal strain: r=0.480, 0.418, 0.582; strain rate: r=0.292, 0.319, P<0.05). Conclusions:The longitudinal strain and strain rate of the plaques are positively correlated with the macrophage and lipid core content of the plaques, and the r values of the upstream of plaques are higher. Therefore, VVI technique is valuable in detecting the stability of the plaques.
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Objective:To explore the application value of artificial intelligence-assisted diagnosis model based on convolutional neural network (CNN) in the differential diagnosis of benign and malignant breast masses.Methods:A total of 10 490 images of 2 098 patients with breast lumps (including 1 132 cases of benign tumor, 779 cases of malignant tumor, 32 cases of inflammation, 155 cases of adenosis) were collected from January 2016 to January 2018 in Beijing Tiantan Hospital Affiliated to the Capital University of Medical Sciences. They were divided into training set and test set and the auxiliary artificial intelligence diagnosis model was used for training and testing. Two sets of data training models were compared by two-dimensional imaging (2D) and two-dimensional and color Doppler flow imaging (2D-CDFI). The ROC curves of benign breast tumors, malignant tumors, inflammation and adenopathy were analyzed, and the area under the ROC curve (AUC) were calculated.Results:The accuracies of 2D-CDFI ultrasonic model for training group and testing group were significantly improved. ①For benign tumors, the result from training set with 2D image was: sensitivity 92%, specificity 95%, AUC 0.93; the result from training set with 2D-CDFI images was: sensitivity 93%, specificity 95%, AUC 0.93; the result for test set with 2D images was: sensitivity 91%, specificity 96%, AUC 0.94; the result for test set with 2D-CDFI images was: sensitivity 93%, specificity: 94%, AUC 0.94. ② For malignancies, the result for training set with 2D images was: sensitivity 93%, specificity 97%, AUC 0.94; the result for training set with 2D-CDFI images was: sensitivity 93%, specificity 96%, AUC 0.94; the result for test set with 2D images was: sensitivity 93%, specificity 96%, AUC 0.94; the result for test set with 2D-CDFI images was: sensitivity 93%, specificity 96%, AUC 0.94. ③For inflammation, the result for training set with 2D images was: sensitivity 81%, specificity 99%, AUC 0.91; the result for training set with 2D-CDFI images was: sensitivity 86%, specificity 99%, AUC 0.89; the result for test set with 2D images was: sensitivity 100%, specificity 98%, AUC 0.98; the result for test set with 2D-CDFI images was: sensitivity 100%, specificity 99%, AUC 0.96. ④For adenopathy, the result for training set with 2D images was: sensitivity 88%, specificity 97%, AUC 0.94; the result for training set with 2D-CDFI images was: sensitivity 93%, specificity 98%, AUC 0.94; the result for test set with 2D images was: sensitivity 94%, specificity 98%, AUC 0.93; the result for test set with 2D-CDFI images was: sensitivity 88%, specificity 99%, AUC 0.90. Its diastolic accuracy was not affected even if the maximum diameter of the tumor was less than 1 cm.Conclusions:Through the deep learning of artificial intelligence based on CNN for breast masses, it can be more finely classified and the diagnosis rate can be improved. It has potential guiding value for the treatment of breast cancer patients.
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Objective:To analyze the ultrasound examination and computed tomography angiography (CTA) features of carotid web(CAW), and compare with the pathology after carotid endarterectomy, and then compare diagnostic efficacies of the two methods.Methods:From June 2018 to July 2019, 159 patients underwent carotid endarterectomy(CEA) in Beijing Tian Tan Hospital were collected, ultrasound examination and CTA were performed preoperatively. The presence or absence of CAW and whether there were thrombosis or atherosclerotic plaques associated with it were identified. The location length, thickness, direction in the lumen, echo characteristics of CAW, and complicated with or without thrombosis or atherosclerotic plaques were recorded. The postoperative specimens were observed, and the pathological analysis was performed.Results:Among the 159 cases of CEA, 22 cases were confirmed to have CAW structure by pathology, and HE staining showed extensive intimal fibrohyperplasia and mucoid degeneration, among which 18 cases had plaque formation at the bottom of the carotid web, and 4 cases associated with thrombosis. There were 17 cases of CAW structure diagnosed by ultrasound, 5 cases were misdiagnosed or missed, the sensitivity and specificity of ultrasound in the diagnosis of CAW were 77% (17/22) and 98% (135/137), and the accuracy was 75%. Eleven cases of CAW were diagnosed by preoperative CTA, and 11 cases were misdiagnosed and missed diagnosis, the sensitivity and specificity of CTA in the diagnosis of CAW were 50%(11/22) and 97%(134/137), and the accuracy was 47%.Conclusions:The sensitivity of ultrasound in the diagnosis of CAW is higher than that of CTA, which can better display the structure of CAW and whether it is associated with plaque or thrombosis.
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Objective To observe the ultrasonographic findings of patients with basal ganglia hemorrhage by transcranial color-code sonography ( TCCS) and contrast-enhanced transcranial color-code sonography (CE-TCCS) ,and to evaluate the clinical value of TCCS and CE-TCCS in assessing the cerebral perfusion with basal ganglia hemorrhage . Methods Eighty-two patients with basal ganglia hemorrhage were selected ,and hematoma was seen in 58 patients (70 .7％ ) . Forty-six cases of bilateral TCCS with clear display of basal ganglia through temporal window were selected . CE-TCCS was used to observe cerebral perfusion of edema zone ,edema zone edge and peripheral brain parenchyma . Results The bilateral rate displayed by TCCS was 79 .3％ . Among 58 cases ,30 cases had ventricular compression ,14 cases had hematoma rupture into ventricle ,8 cases had midline displacement ,and 10 cases had no complication change . The cerebral perfusion in edema areas around hematoma was reduced by CE-TCCS ,but the degree of reduction was different . There were reduced in a step-like manner in the cerebral perfusion from edema zone and edema zone edge to peripheral brain tissue . Conclusions CE-TCCS is a new method for clinical diagnosis and monitoring the progress of treatments of cerebral hematoma .
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Objective To investigate the capability oftomography ultrasound (TUI) in evaluating the development of the normal anorectal structure to provide a reference for prenatal diagnosis of imperforate anus.Methods From June 2017 to July 2018,315 singleton pregnant women at 19-40 weeks of gestational age were selected from Beijing Tiantan Hospital,and they ranged in age from 23 to 40 years,with an average age of 29±3 years.The TUI technique was applied to measure the fetal anal sphincter diameter (ASD),anal canal diameter (ACD),and anal canal length (ACL).The correlation between ASD,ACD,or ACL and gestational age was analyzed by Pearson correlation analysis,and the regression equation and curve were established.The intraclass correlation coefficient (ICC) and 95％ confidence interval (CI) were used to evaluate the repeatability of the measurement ofASD,ACD,and ACL.Results The display rate of fetal anorectum in all fetuses by the TUI technique was 97.8％ (308/315).Pearson correlation analysis showed that the normal fetal ASD,ACD,and ACL were positively correlated with the gestational age of the fetus,and the regression equations are:ASD,Y=-0.001X2 + 0.421X-1.726 (r=0.83,P ＜ 0.01);ACD,Y=0.418X-4.207 (r=0.89,P ＜ 0.01);and ACL,Y=0.526X-1.062 (r=0.87,P ＜ 0.01).Conclusion TUI for assessment of fetal anorectum is feasible.This method can be applied to improve the display rate of fetal anorectum.
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Purpose To discuss the clinical value of applying tissue motion tracking of mitral annular displacement (TMAD) technique to evaluate left ventricular global systolic function in patients with coronary heart disease. Materials and Methods Sixty patients with coronary heart disease who had at least one coronary stenosis ≥70% confirmed by coronary angiography were selected, and 35 healthy volunteer were enrolled as the control group. Three to five sequential two-dimensional dynamic images of cardiac cycle of four-chamber, three-chamber, and two-chamber apex cordis were collected and stored, and Qlab 7.0 software was used for off-line analysis. Maximal systolic displacement (Ds) of mitral annulus in six sites, systolic displacement of the middle point (D-mid) and left ventricular longitudinal fractional shortening (FSL) were measured and calculated for mean value respectively, which were then used for correlation analysis with left ventricular ejection fraction (LVEF) measured by simplified dual plane Simpson. Results ①Compared with control group, the mean value of Ds, D-mid and FSL of group A and B were significantly decreased, the difference of which was statistically significant (P<0.05). Compared with group A, the mitral annulus displacement parameters of group B decreased, the difference of which was statistically significant (P<0.05). ②Compared the time used for the two measuring methods: TMAD technology significantly reduced the measuring time compared to the two-dimensional dual plane Simpson's method (P<0.001). ③The mean values of Ds, D-mid and FSL in the control and coronary heart disease groups were all correlated with LVEF (r=0.77, 0.75, 0.78, P<0.001; r=0.78, 0.79, 0.78, P<0.001). ④Repeatability test: the intra-observer ICC values of the mean values of Ds, D-mid and FSL were 0.87, 0.85 and 0.93 respectively, and the inter-observer ICC values were 0.84, 0.84 and 0.88 respectively. Conclusion TMAD technology is time-saving, accurate and reproducible, which can be used to evaluate left ventricular systolic function in patients with coronary heart disease.
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Aim To investigate the effect of polysac-charide of Cistanche deserticola ( CDPS) on the impro-ving ability of synaptic plasticity in memory acquisition impairment model mice induced by scopolamine. Methods The KM mice were randomly divided into six groups:scopolamine group, control group, CDPS-treated (25, 50, 100 mg·kg-1 ) group and donepezil group. Memory acquisition impairment model in mice was established with i. p. scopolamine (4 mg·kg-1 ) only once, and orally administered CDPS (25, 50, or 100 mg · kg-1 ) daily for 6 weeks before scopolamine injection. Experimental groups were subjected to step-down test and Morris water maze test. Western blot and RT-PCR analysis were used to examine the expression of GAP-43 , SYP and PSD-95 . Transmission electron microscope was used to observe the change of synaptic number and structures. Results CDPS (25,50,100 mg·kg-1 ) could shorten the incubation period of mice in the water maze test. Control group and CDPS-treated group swam longer in Q3 than scopolamine group. Mo-reover, CDPS (50,100 mg·kg-1 ) could significantly reduce the error times and extend the incubation period in the step-down test. The results of Western blot and RT-PCR showed that CDPS significantly improved the expression of GAP-43 at the dose of 25 ,50 mg · kg-1 and SYP at the dose of 25,50, 100 mg·kg-1 in hip-pocampus of mice. However, the biochemical assays did not reveal a significant difference in the basal hipp-ocampal levels of the PSD-95 . The ultra-thin speci-mens of hippocampus showed that the number of syn- apse was increased in CDPS-treated group. Conclu-sions Scopolamine can induce the learning and mem-ory deficits in mice to make related protein expression abnormalities in hippocampus mice, thus this causes the change of synaptic plasticity, which leads to a change in the ability of learning and memory. And CDPS can improve the expression of SYP and GAP-43 , increase number of synapses, recover synaptic plastici-ty, and improve the ability of learning and memory in mice.
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Objective To explore contrast-enhanced ultrasonography (CEUS) in diagnosis renal injuries complicated with active bleeding of different velocity,and analysis the related factors of renal traumatic degree.Methods Thirty-four Ⅰ - Ⅴ grade lesions of renal injury were made in 4 dogs and 6 New Zealand rabbits.Two and three dimensional CEUS were used to observe traumatic extension,and traumatic position,involving in vascular as well.Then the injury condition was classified and assessed synthetically.Results The range of lesions observed by using 2D and 3D ultrasound had consistency with those of the pathologic sample (length-diameter:F =0.4724,P =0.6252; transverse diameter:F =1.6174,P =0.20490),3D-CEUS can display the vascular that involved by renal injury.In the same traumatic extension condition,the time of animal becoming shocked and injury severity was related to not only traumatic extension but also different velocity of active bleeding and involving in vascular.Conclusions Contrastenhanced ultrasound can objectively reflect renal injury severity,and more information can be provided to clinical for management.
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ObjectiveToexplore the appearance ofmusclecrushinjuryatquantitative ultrasonographic elastography by supersonic shear imaging (SSI).MethodsThe animal experiment was done using a special balloon cuff device to create left hind leg crush injury with a force of 18.6 kPa.Twentythree New Zealand rabbits had crush injury of extremity and survived for 72 hours.SSI quantitative elastography was performed in crushed and no-crushed regions of each rabbit hind leg.Quantitative lesion elasticity was measured in terms of the Young modulus (in kilopascals) at 30 min,2 h,6 h,24 h and 72 h after the release of the crushing pressure.A receiver operating characteristic (ROC) curve analysis was used to assess diagnostic performance.ResultsThe area of crushed region in left hind leg accounted for 2.6％ -3.0％ of body surface area in 23 rabbits.The crushed regions exhibited maximum elasticity values of (19.51 ± 6.74)kPa,(21.47 ± 5.54) Pa,(11.36 ± 5.35)kPa,(15.09 ± 3.31)kPa and (13.72 ± 3.74) kPa,and mean elasticity values of (12.44 ± 3.77)kPa,(13.20 ± 3.60)kPa,(6.80±2.86)kPa,(10.04 ± 2.95)kPa and (6.94 ± 0.97)kPa at 30 min,2 h,6 h,24 h and 72 h after the release of the crushing pressure.Comparing with those of no-crushed regions,they were higher obviously (P＜0.001).ROC curves showed that extremity crush injury was diagnosed by using elasticity value,and the greater the elasticity value,the greater the diagnostic value.Conclusions SSI provides quantitative elasticity measurements,thus adding complementary information that potentially could help in crush injury characterization with conventional ultrasonography.
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Objective To approach the diagnostic value of contrast-enhanced ultrasonography(CEUS)for the detection of traumatic laceration of pancreas. Methods Sixty cases of pancreatic traumatic model were made in twelve healthy swines after the animals were anesthetized and laparotomized. Then the conventional ultrasonography(US) and CEUS were performed in each case to diagnose the traumatic region,immediately. The results were compared with surgical findings. Results Among sixty injuries,the detection rate of conventional ultrasonography was 66. 7%,the detection rate of CEUS was 88.3%. Conclusions CEUS shows higher detection rate than conventional US in diagnosing pancreatic laceration,and it also can improve the diagnostic value of ultrasound for the detection of pancreatic laceration.
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Objective To study feasibility of combined haemostatic percutaneous injection therapy guided by contrast-enhanced ultrasonography (CEUS) in treatment of renal injuries. Methods Eighteen New Zealand rabbits were inflicted with kidney injury imitating grades Ⅲ-Ⅳ blunt injuries. The animals were randomly and equally divided into three groups, Group A ( treated with hemocoagulase),Group B ( treated with hemocoagulase and Alpha-cyanoacrylate) and Group C ( control group, given normal saline). The hemostatic time, hemostatic effect, and perirenal hematoma were observed. Results A perirenal hematoma was observed one hour after treatment. The perirenal fluid thickness was (0.200 ±0.012) cm in Group A, (0.050 ±0.002) cm in Group B and (0.400 ±0.009) cm in Group C, with statistical significance between two test groups and Group C (P ＜ 0.05 ). At days 7 and 14 following treatment, lesion length and cross section was ( 1. 107 ±0. 143) cm and (0.433 ±0. 163) cm in Group A, (0.567 ±0.082) cm and (0. 160 ±0. 078) cm in Group B, and (0.980 ±0. 203) cm and (0.686 ± 0. 157) cm in Group C. There was statistical significance between the test groups (Groups A and B) and Group C (P＜0. 01) at day 14. The lesion size in Group A was lager than that in Group B (P ＜ 0.01 ). One month after treatment, a slight nephrohydrosis occurred in Group B. Conclusions Either injection of simple hemocoagulase or combined use of hemocoagulase and Alpha-cyanoacrylate guided by CEUS can attain positive hemostatic effect, but the latter one is more rapid and reliable.
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Objective To study haemostatic percutaneous injection therapy for the management of vascular damage in patients with renal injuries guided by contrast-enhanced ultrasonography(CEUS).Methods Which of 56 patients with renal trauma were diagnosis by CEUS,37 cases with grades Ⅱ-Ⅳ renal injuries were brought into our study.According to wound degree and accompanying active bleeding,they were divided into experiment group (percutaneous injection hemostatic treatment)and control group(conservative treatment).Results Thirty-seven renal trauma manifest low perfusion in lesions by CEUS,and the contrast agent could be seen overflow to renal pelvi and the location of capsule in 13 patients.The patients were divided into experiment group(17 cases)and control group(20 cases).The color of hematuria of 9 patients in experiment group became gradually light at 30 mins after treatment.and the color of 7 cases become normal,and hematuria of the only one was iterative appear.The color of hematuria of 9 patients in control group became gradually light in 24-72 hours,others' hematuria became gradually light in 5-14 days.The time of color of hematuria become light of the former was shorter than those of the latter(P<0.05).Reexamination by ultrasound and renal function and urine routine at 1,3 and 6 months after treatment,the results of all patients indicated normal.Conclusions Haemostatic percutaneous injection therapy for renal trauma guided by contrast-enhanced ultrasonography has very obvious hemostatic efficacy.Its advantages included may be used for effective,minimally invasive control of renal injuries(grades Ⅱ-Ⅳ),and can be a feasible management of active bleeding at bedside.